Rehab 4 Addiction

Tramadol is an opioid which is used for pain management. As with most opioids, it is highly addictive and can lead to withdrawal symptoms even if taken at the dose and frequency recommended by a doctor.

One reason Tramadol is popular as a prescribed pain medication is due to its relatively low number of adverse side effects compared to other opioid analgesics.

This drug is often used to treat chronic pain, but the risk for developing dependency over time rises each time the dose is increased to accommodate growing tolerance.

Because Tramadol doses must be continually increased over time, the longer a person is on the drug, the more severe the withdrawal symptom will be when they appear.

Tramadol affects various body systems, including mu-opioid receptors, serotonin, and catecholamines which means each of these become unbalanced during withdrawal.

Thankfully, Tramadol is fast-acting in terms of how long it takes for the symptoms of withdrawal to cease once it has been discontinued.

Unfortunately, it has several unusual severe side effects that can sometimes come into play, including psychosis, hallucinations, and anxiety.

This drug should never be discontinued without the oversight and support of medical professionals as it can be highly dangerous to attempt to stop taking it without instituting a tapering off process.

By slowly decreasing the dose until it is no longer in a person’s system, many of the adverse effects can be avoided. Flu-like symptoms are more common when utilising this method of quitting.

The Effects of Tramadol

Tramadol changes serotonin and norepinephrine in the brain leading to feelings of calm, happiness, and euphoria. These can quickly become addictive, especially if a person finds themselves psychologically dependent.

In addition to the tolerance that builds up, there will also be cravings. Increasing the dose is the only way to continue to experience the euphoria that comes with the drug so some people will begin finding alternate sources of Tramadol to satisfy this need in addition to their prescribed amount.

This likelihood increases if someone has previously experienced issues with substance abuse disorders. Being taken in an amount higher than prescribed can lead to overdose and medical complications, including accidental injuries.

No one is entirely certain how this drug works, but it is known that discontinuing it can lead to dangerous effects on the mind and body. The neurochemicals that it alters while being used will fall into a disturbed overdrive once the body no longer is able to rely on the drug.

This can lead to a host of symptoms varying in degrees from mild to intense. Most of the worst can be avoided by a slow tapering off of the drug, but that is not a complete guarantee that atypical symptoms will not emerge.

Common Symptoms of Tramadol Withdrawal

This drug is more active in the brain than other opioids which means that during withdrawal, the symptoms can have significant effects on a person’s perceptions and functioning.

It works primarily by inhibiting serotonin and norepinephrine reuptake while simultaneously stimulating mu-opioid receptors. Symptoms can vary in severity.

There are risk factors associated with the more intense ones, including a personal history of substance abuse disorders and any dual diagnosis.

There are two main types of symptoms during Tramadol withdrawal. They are considered typical and atypical with the latter consisting of more hazardous and unpredictable conditions.

The typical symptoms of Tramadol withdrawal generally consist of the following:

  • Flu-like symptoms (e.g., nausea, stomach pain, sweating, diarrhoea, vomiting, body aches and pains, and headache)
  • Muscle tics
  • Unexplained crying
  • Sleep disturbance (e.g., insomnia, nightmares)
  • Moderate anxiety
  • Body tremors and shivering
  • Cravings
  • Restlessness, irritability, and agitation
  • Blurred vision
  • Dizziness
  • Unusual mood swings
  • Numbness or a prickling feeling in the extremities
  • Crying for no discernible reason
  • Increased heart rate
  • Depression

More intense symptoms are possible. While death from withdrawal symptoms alone is unlikely at this stage even when detoxing alone, there is a high risk of accidental injury.

Anyone attempting withdrawal should be under medical supervision until the worst is over. The atypical symptoms of Tramadol withdrawal include the following:

  • Severe anxiety
  • Paranoia
  • Sensory overload
  • Panic attacks
  • Hallucinations and delusions
  • Severe paranoia
  • Tinnitus
  • Mental confusion and disorientation
  • Depersonalisation and derealisation

It has also been noted that depression and other mood disorders can result from decreasing or detoxing from Tramadol. This can lead to self-harming behaviours in some individuals.

Quitting Tramadol Without Medical Supervision

Anyone who tries to quit Tramadol without medical supervision will find themselves going through increasingly painful and destabilising effects.

This often leads to relapsing, which significantly raises the risk of an overdose. Even in cases where quitting cold turkey does not lead to relapse, there will still be uncomfortable and potentially dangerous side effects that can cause a person to put themselves in hazardous situations.

Accidental injury, severe anxiety reactions, and even the flu-like symptoms can all lead to being hospitalised. In addition, there will be strong cravings to contend with throughout the detox period.

Individuals who wish to stop taking Tramadol should work with their physician to decrease the dose slowly over time. This is the only safe way to stop taking the drug.

There may still be symptoms, but they will be manageable and less uncomfortable. There is no cookie-cutter approach to tapering off

Tramadol, which means that each person must work closely with a doctor to find the right rate decrease between each dosage change to avoid the worst atypical effects.

A Timeline of Tramadol Withdrawal

Withdrawal will generally begin only several hours after the drug is discontinued or the dose is lowered substantially. The period it takes to detox from Tramadol and stops exhibiting symptoms completely can vary depending on several factors including genetics, physiology, and how quickly it is tapered off.

Most symptoms will develop at some point throughout the first seven days. There are two primary phases of withdrawal.

During this time, the majority of individuals only experience typical withdrawal symptoms expected from ceasing any opioid, but around ten per cent will experience psychological distress.

Symptoms peak quickly, usually within the first few days and then slowly diminish over time until they disappear altogether once detox is complete.

How long it takes precisely will depend on how quickly the drug doses are reduced and any other co-occurring medical disorders that may impact the timeline.

1. Early Tramadol Withdrawal (Days 1 – 7)

The first three days are accompanied by uncomfortable flu-like symptoms, including those listed below.

  • Numbness or a prickling feeling in the extremities
  • Sweating, nausea, headache, and vomiting
  • Anxiety, nervousness, and heart palpitations
  • Insomnia or other sleep disturbances
  • Cravings for the drug

Days four to seven can show an increase in insomnia and sleep disorders and the onset of mental confusion or disorientation.

These will be kept to a minimum by working closely with a medical professional and reporting any adverse reactions so that necessary dose adjustments can be made.

2. Late Tramadol Withdrawal (Days 8 – 14)

The majority of physical symptoms will have disappeared by the end of this time period. However, psychological ones such as depression, irrational thoughts, and anxiety may persist and require additional medical intervention to help with the transition.

Therapy and medications can assist with lowering or eliminating these lingering effects of Tramadol withdrawal.

What to Expect From Tramadol Detox

Detoxing is the process through which a drug is purged from a person’s system. During that time, the body attempts to regain equilibrium and adapt to the loss of the chemicals that had been provided by the drug.

It can lead to some or all of the previously mentioned withdrawal symptoms. Tramadol detox should be overseen by an experienced doctor to cut down on the possibility of relapse and withdrawal complications.

The doctor in charge of overseeing the tapering of the process of Tramadol may prescribe other medications to help counter symptoms.

They will ensure that detox is as painless as possible. Some of the commonly prescribed medications include the following:

  • Metoclopramide
  • Nausea and vomiting
  • Loperamide
  • Diarrhoea
  • Ibuprofen or Acetaminophen
  • Muscle aches
  • Clonidine
  • Anxiety and sweating
  • Valium
  • Anxiety and insomnia
  • Buprenorphine (Subutex)
  • General symptom relief
  • Suboxone (a combination of Buprenorphine and Naloxone)
  • Stops the euphoria caused by opioids and for overall symptom relief

Long-term, chronic Tramadol use at high doses will lead to more intense atypical symptoms and may take longer to fully detox from since the initial amount is so high and it must be lowered in small increments over time.

It is not unusual to spend the entire detox in a facility where a medical team can adjust and prescribe medication as needed to keep the individual going through withdrawal safe and comfortable.

Most symptoms will start to fade away within a week when the detox is under the supervision of a doctor. It might take longer if the drug was used over a long period or at unusually high doses.

As is the case with any drug withdrawal, there is always the chance that a person may undergo post-acute withdrawal symptoms. These can take place after the withdrawal period of one to two weeks and may appear suddenly and last for months before slowly disappearing again.

Some common symptoms of post-acute withdrawal symptoms include those listed below:

  • Anxiety
  • Depression
  • Insomnia
  • Lowered appetite
  • Irritability
  • Mood swings
  • Inability to concentrate

Tapering Off Tramadol Under Medical Supervision

Any opioid-based pain relief medication has the potential to be abused. When attempting to detox alone, people often find themselves overwhelmed by the symptoms and then they relapse. In that state, it is easier to overdose or injure oneself accidentally.

The only safe way to stop taking Tramadol is by allowing a doctor to set up a tapering off schedule, which will slowly lower the dose of the medication over time. This will help eliminate the worst of the symptoms and make success more likely.

Due to Tramadol being a serotonin and norepinephrine reuptake inhibitor there is a more significant potential for adverse psychological reactions to lowering the drug (e.g., mental confusion, delusions, paranoia, anxiety, depression, sensory overload, etc.).

This is one reason why there is no clear-cut tapering method since what works for one person’s brain may not be right for others. Instead, a methodical approach is required wherein each lowering of Tramadol dosage is monitored and increased or decreased as needed.

Tapering schedule may vary, but the rule of thumb is to lessen the dose of Tramadol ten per cent a day for anyone on lower doses who have not been on the medication for very long or ten per cent per week for those who have been on it longer or experienced larger quantities.

No matter which schedule is chosen, the result will be an easier withdrawal than one might experience alone or quitting cold turkey.

Commonly Used Treatments for Tramadol Withdrawal

Once psychological addiction occurs, medical supervision must be used to help the individual detox from the drug. This ensures minimum withdrawal complications.

There are both residential and out-patient options depending on the severity of the withdrawal effects. For cases where the patient was a chronic substance abuser or used high doses of Tramadol, attend a residential treatment facility is recommended.

There are other treatments that can be utilised during the withdrawal period and afterwards. These include one-on-one therapy to assist with psychological symptoms.

Group therapy, family therapy, and other community substance abuse programmes will also make the process less taxing. Aftercare is essential for anyone going through addiction recovery. This can include prescription medications, therapy, and other treatments.

Managing Tramadol Withdrawal With Medications

Intense cravings are a part of Tramadol withdrawal regardless of the severity of other symptoms. During medical supervision, it is not unusual to be given medications to help counter these cravings to eliminate the risk of a relapse.

The three most commonly used prescription medications to assist the craving aspect of Tramadol withdrawal include methadone, buprenorphine, and naltrexone.

1. Methadone

Methadone is an opioid that is used because it will replace the effects of Tramadol in the brain without creating the same overwhelming euphoric sensation that is so addictive.

It is long-acting, which makes it ideal for using to aid with tapering off Tramadol, which is faster-acting. There is still a mild euphoria that might be produced.

Any opioid can become addictive even when used in small doses over a short period, so it should be used cautiously to counter psychological symptoms.

2. Buprenorphine (e.g., Suboxone, Zubsolv, and Bunavail)

Buprenorphine is a partial opioid agonist, but it will still work in much the same way as methadone. It is long-lasting as well but weaker than methadone which means that it takes a higher dose to be effective.

Buprenorphine has a plateau effect, so there is less chance of it being abused. This makes it ideal for both typical and atypical withdrawal as there is a much smaller chance of overdose or developing an addiction to buprenorphine.

3. Naltrexone (e.g., Vivitrol, ReVia, and Depade)

Naltrexone is another opioid antagonist which is used to block opioid receptors. It can help manage cravings and the desire to relapse.

Naltrexone does not create addiction or tolerance, which makes it ideal for being used in the first phase of Tramadol withdrawal when the cravings are the worst. It has been proven to provide relief from cravings and a decrease in risk for relapse.

Residential Treatments for Tramadol Addiction

If someone chooses to attend a residential treatment facility, then there will be multiple programmes designed to create an environment where holistic recovery is encouraged.

  • Nutritional Management: A healthy diet is vital. Residential treatment includes introducing regular, nutritionally balanced meals to aid in a faster recovery. Light exercise is also encouraged
  • Psychological Treatments: Various one-on-one counselling options are available with the most common being cognitive-behavioural therapy. There are also group therapy sessions where everyone attending the programme can share their experiences, struggles, and successes. Therapy can provide positive coping mechanisms for cravings and make it easier to overcome the psychological effects of Tramadol withdrawal (e.g., depression, anxiety, paranoia, panic attacks, etc.). These treatments usually continued during aftercare as well to make the transition between residential treatment and day-to-day life more manageable. Another primary goal of therapy is to find ways to deal with emotional issues healthily. One reason some people are more susceptible to addiction is that they crave the happiness and euphoria that accompanies opioid use as a way of avoiding negative emotions or overwhelming situations in their life. A therapist can show them how to use reframing methods and alternative thought patterns. Emotional stability may take some time to achieve fully, but individual and group therapy are helpful.
  • Education About Addiction: Understanding the effects of addiction on the body and mind is essential for lowering the risk of future substance abuse. Everyone should be aware of how opioids and other addictive substances can change their bodies. These lessons are meant to be a preventative measure